Integrating Knowledge from Diverse Studies for Predicting Impact and Cost of Prevention

It is time to strategically combine science, action, and accountability to tackle the persistent public health problem of preventable suicide.  Research can identify promising directions for action, but taking action—delivering prevention services and monitoring their success—is the responsibility of policy makers, agency heads, and system leaders.  Decision makers need help, however, in deciding whom to target, with which interventions, and in what order of priority.  The Research Prioritization Task Force of the National Action Alliance for Suicide Prevention began to address these questions by using existing data to stratify suicide risk among subsamples of the population, identify feasible and effective interventions for different care settings (such as clinical interventions, organizational practices, and policies), estimate the impact of specific interventions when applied to particular subpopulations, and strengthen accountability for results when estimation models show that large reductions in suicide are possible.  Similar approaches have been effective in reducing deaths from other causes (e.g., heart attacks, alcohol-related traffic accidents).  This suggests that steep reductions are also possible with suicide deaths given strategic use of research, targeted action, and public accountability.  Population-based data from publically available sources, including the Web-based Injury Statistics Query and Reporting System and the National Survey on Drug Use and Health, can be used to help direct such a public health–based suicide prevention strategy.  These and other data sets can be mined to reveal, for example, that definable subgroups receiving care through identifiable service systems (e.g., individuals in specialty substance use treatment) have higher concentrations of suicide risk than the general public and other subgroups.  Such findings can help to prioritize certain suicide prevention strategies over others as an efficient way to methodically target care to those with heightened need.  Data sets that are available for these purposes have both strengths and weaknesses.  This presentation will introduce the approach that the Research Prioritization Task Force used to stratify suicide risk, model intervention results, and encourage accountability.  It will conclude with suggestions for strengthening public data resources in the service of reducing suicide in the U.S.